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Individual

MS. JESSICA B WAGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
244 MEDSPRING DR, CLAYTON, NC 27520-9293
(919) 359-0291
(919) 553-2907
Mailing address
244 MEDSPRING DR, CLAYTON, NC 27520-9293
(919) 359-0291
(919) 553-2907

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04444
NC

Other

Enumeration date
09/05/2013
Last updated
03/30/2021
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